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Breath Holding Spells

Question of the Week

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Updated July 31, 2008

Q. What could it be when a 2 year old faints and goes stiff and tuns a purple color. It kind of looks like she went into shock. My daughter been doing that since she's been 6 months old. She gets hurt, like after she falls down, then cries and goes stiff. Or she cries when she wants someone to pick her up or wants attention till she kind of loses her breath and does the same thing. This last time she passed out and she was out not breathing for almost a whole minute. Her dad thinks it might be anxiety attacks. Nobody gives me any answer. Theresa, Pasadena

A. It sounds like she is having breath holding spells.

And while scary for parents, they are usually considered to be normal.

These spells usually occur when a child begins crying, either because of a fall or a temper tantrum, and then involuntarily holds his breath and faints. During a spell, a child will become blue and limp and then quickly begins breathing again and wake up.

This type of cyanotic breath holding spell usually begin when a child is between 6 to 18 months and are outgrown when they are about 4 to 8 years old. Unfortunately, until they are outgrown, they may occur once a year, once a month, or even more frequently.

Children can also have pallid breath holding spells, in which something painful happens, and they quickly turn pale and pass out without crying very much.

Breath holding spells are often mistaken for seizures, especially if they occur after a fall and the child makes some jerking movements before waking up, but unlike children who are having seizures, these children will have a normal EEG test.

Although extensive testing is not necessary for most children with simple breath holding spells, since they are associated with iron deficiency anemia, a blood test to check for anemia might be a good idea if that hasn't been done yet. An EKG test is also sometimes done for these children to look for an underlying heart problem.

If you are not getting a clear answer about these episodes from your Pediatrician, you might get a second opinion from a child neurologist.

Avoiding Breath Holding Spells

Since breath holding spells usually follow crying and tantrums, you can to try to avoid them by preventing temper tantrums. This doesn't mean giving in to your child's tantrums, since that will likely just teach her that tantrums work and she will probably have even more. Instead, distract her when you see a tantrum coming and before it really gets started.

It can also help to keep your child on a regular routine, set limits, and avoid things that are sure to frustrate your child and trigger a tantrum, like allowing her to get hungry or overly tired. See our guide to temper tantrums for more information and advice.

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How to Avoid Temper Tantrums

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